Is your child feeling more thirsty than usual these days? Does he need to urinate more often? Does he feel like he's losing weight even though he's eating well? These may seem like simple things, but they can sometimes be the first signs of a condition called Type 1 diabetes in children. This is a chronic condition that is common among children. So as parents, it's important for us to be aware of this and not panic about it.
Simply put, what is Type 1 diabetes in these children?
Type 1 diabetes is an autoimmune condition. Simply put, our body's immune system (the army that protects us from disease) mistakenly attacks and destroys the insulin-producing cells (called beta cells) in our own pancreas.
Think about it, insulin is the key that opens the door for the sugar (glucose) in our blood to enter the body's cells. So when these insulin-producing cells are destroyed, the body stops producing the insulin it needs. Then the blood sugar level rises dangerously. This is called Type 1 diabetes.
Many people confuse Type 1 and Type 2 diabetes. In Type 2 diabetes, the body produces insulin, but the cells do not respond to it properly (insulin resistance). In Type 1, however, insulin production stops. Therefore, a child with Type 1 diabetes must be given insulin from outside sources every day to survive.
Although this condition can occur at any age, it is most commonly seen around the age of 5 or during early adolescence (10-14 years).
Why do children get this condition?
There is no single exact cause for this, but doctors believe it is mainly a combination of two factors:
1. Genetic Predisposition: Some children have a genetic predisposition to developing autoimmune diseases. In particular, variations in the gene system called ``(HLA)`` have been found to be related to this.
2. Environmental Triggers: This disease does not develop simply because of a genetic predisposition. It needs to be triggered by some environmental factor. Some of these factors include:
- Some substances that the mother is exposed to before the baby is born.
- Some viral infections that a child may contract during childhood.
- The child's diet.
- The community of beneficial bacteria in the body (`microbiome`).
For these reasons, the immune system becomes confused and begins to produce antibodies (`autoantibodies`) against the cells that make insulin. Over time, when these cells are completely destroyed, the symptoms of diabetes begin to appear.
How to recognize it? - Main symptoms and emergencies
Watch for these symptoms in your child. They can gradually worsen over days, weeks, or months.
| Symptom | Description |
|---|---|
| Excessive thirst | The urge to drink more water than usual. |
| Peeing a lot | Even a child who is toilet trained can start wetting the bed at night. Small babies' nappies fill up quickly. |
| Weight loss despite eating well | Inexplicable weight loss despite eating well. |
| Excessive hunger | Asking for food more often than usual, claiming to be hungry. |
| Fatigue | The child is constantly sleepy and lifeless. |
| Blurred vision | The child may be able to tell you about any changes in vision. |
| Emergency requiring immediate attention: DKA (Diabetic Ketoacidosis) | |
| Fruity-smelling breath | Breath smells like fruit, wine, or nail polish remover. |
| Vomiting and stomach ache | Frequent vomiting and severe stomach pain. |
| Rapid breathing | Increased breathing rate. |
| Confusion and drowsiness | The child's behavior changes, confusion, excessive sleepiness, or loss of consciousness. |
Very important: DKA (`Diabetic Ketoacidosis`) is a life-threatening medical emergency. If your child has any of the above DKA symptoms, take them to the nearest hospital's Emergency Department (ETU) immediately.
How can the doctor confirm this?
When you take your child to a doctor, they will do a few simple blood tests to confirm diabetes.
- Blood Glucose Test: Blood sugar levels are measured either while fasting or at any time (random).
- A1c Test: This test can determine the average blood sugar level of the child over the past three months.
- Antibody Test: Once the disease is confirmed, the blood is tested for the presence of antibodies (`autoantibodies`) against insulin-producing cells to confirm whether it is Type 1 diabetes.
- C-peptide Level: This test helps determine how much insulin the body is producing. In Type 1 diabetes, this level is very low.
How is it treated? - How to manage this
Type 1 diabetes cannot be cured. But with proper management, your child can live a completely healthy, active life. Your doctor will often refer your child to a doctor who specializes in diabetes (a pediatric endocrinologist). There are three main components to management.
1. Regularly check blood sugar levels (Blood sugar monitoring)
The child's blood sugar level needs to be checked several times a day using a glucometer. Newer Continuous Glucose Monitoring (CGM) devices can also continuously monitor sugar levels through a small sensor placed under the skin.
2. Insulin injections
This is the most important part of management. Your child will need to inject insulin daily, several times a day. Sometimes an insulin pump may be used. The amount of insulin to be given will vary depending on what your child eats, how much exercise they do, and the time of day. Your doctor will explain this to you.
3. Carbohydrate counting and diet
You need to learn to calculate the amount of carbohydrates in your child's diet and determine the insulin dose accordingly. It is very important to seek the help of a dietician for this. The focus here is on providing a balanced, healthy diet.
How do we help a child with diabetes?
This is a challenge for both the parents and the child. But your support and positive attitude are a great strength for the child.
- Stay positive: Most people with Type 1 diabetes live active, healthy lives, so don't be afraid.
- Don't blame your child: Sometimes, even if you do everything right, your blood sugar levels can still go up and down. Instead of scolding your child, focus on what needs to be done at that moment.
- Make your child independent: Gradually teach your child to manage their condition. Practice checking their blood sugar levels and calculating insulin on their own.
- Inform others: Keep the child's family, teachers, and friends informed about the situation. Explain to them what to do in an emergency.
- Be prepared for emergencies: A dangerously low blood sugar level (hypoglycemia) is an emergency. Keep something like a glucagon injection handy to give in case of an emergency. Ask your doctor about it.
Take-Home Message
- Type 1 diabetes is not something that occurs due to the child's fault. It is an autoimmune disease caused by a malfunction in the body's immune system.
- This is a lifelong condition, but it can be very well managed with insulin treatment, a proper diet, and monitoring blood sugar levels.
- If your child is showing symptoms such as excessive thirst, frequent urination, or weight loss despite eating well, see a doctor without delay.
- A fruity smell to the breath, vomiting, stomach cramps, and extreme drowsiness (signs of DKA) are an emergency that requires immediate hospitalization.
- With the right support and education, a child with Type 1 diabetes can live a completely happy, healthy, and successful life.
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